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Inspection on 23/11/09 for 57 Crabbe Street

Also see our care home review for 57 Crabbe Street for more information

This is the latest available inspection report for this service, carried out on 23rd November 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager has maintained a consistently high standard over the eight years she has managed this home and has told us that she remains committed to providing an excellent service to the people living in the home and has uses her expertise to ensure that whatever the residents needs are they are fully meet by a well trained and dedicated staff team. There was a homely, comfortable atmosphere in the home and staff were knowledgeable about the needs of the people in their care. Interaction between the staff and the residents was observed to be friendly and open. When talking about the people living in the home staff did so in a supportive and respectful manner. There is a good quality assurance system in place and maintenance records and fire hazard reporting records were seen and were comprehensively completed.

What has improved since the last inspection?

The activity programme has been further developed and since liaising with the Suffolk College they have arranged for a weekly musical memories activity to take place, facilitated by two students from the college. In the Annual Quality Assurance Assessment (AQAA) the manager told us that there have been several improvements at the home in the last year, these included an increase to in-house training including infection control. A new call bell system has been installed, which they feel has increased the residents sense of security and one of the home`s lifts has been refurbished to allow easier access. Also the conservatory has been refurbished and it has been fitted with a solid roof to help maintain temperature levels as it was prone to getting very hot in sunny weather. All of the windows and doors have been replaced by double glazed units, which have improved security locks. Some of the bedroom carpets have been renewed and all of the corridor carpets have been replaced. New curtains for two communal sitting rooms and two bedrooms have been bought and many rooms have been redecorated. In collaboration with both the local authorities heath and safety executive and the property department, the home has developed an emergency plan in relation to flood, fire, utility failure and infection outbreak. A mock disaster event was successfully staged.

What the care home could do better:

The service has been assessed as giving excellent outcomes to the people living there and we didn`t identify any areas that needed improvement. However the manager acknowledges that there is always room for improvement and continues to make plans to improve the home.

Key inspection report Care homes for older people Name: Address: 57 Crabbe Street 57 Crabbe Street Ipswich Suffolk IP4 5HS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ann Wiseman     Date: 2 3 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: 57 Crabbe Street 57 Crabbe Street Ipswich Suffolk IP4 5HS 01473588508 01473712869 Pam.Purnell@socserv.suffolkcc.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Suffolk County Council care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 57 Crabbe Street is a local authority owned home for older people and is located in a quiet area of East Ipswich, within walking distance of local shops. The centre of the town can be reached by bus. The building is two storeys and was purpose built as a care home in 1969. It was extensively refurbished during 1997 to a high standard and its registration was changed to provide accommodation for thirty one people who have a diagnosis of dementia. The home is split into five small units, each of the units is self-contained and has a sitting room, combined kitchen and dining room, bath and laundry facilities. Meals are provided from the main kitchen but residents are supported to cook simple meals, cakes and snacks. All the bedrooms are single and have an en-suite facility comprising Care Homes for Older People Page 4 of 29 Over 65 31 13 0 0 Brief description of the care home of a shower, hand basin and WC. The central kitchen is well equipped, and in addition to providing meals for the residents, they also provide meals for those using the day care facility which is part of the building and also a number of community meals. People living at the home also have access to a hairdressing service at the home. There is an attractive garden, which is well maintained and can be accessed by wheelchair users. The garden provides seating and cover from the hot weather. The local authority will carry out a financial assessment to establish what people will pay for their accommodation, the fee, for those people paying the full cost of their stay, is in the region of £720 per week, but people should check the current fee with the manger. Food and accommodation is included in the costs and an extra charge will be made for toiletries, newspapers, hairdressing and outings. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection; we arrived at 10.00am in the morning and stayed for eight hours. The manager was at the home when we arrived and facilitated the inspection, which she did in an open and helpful manner. Whatever files and documents we asked to see were produced quickly. Before the inspection we had sent surveys to home for distribution among the residents, staff and professionals involved in it. We had a good response with 13 residents returning their survey, 12 staff members completed theirs and we had two returned from other professionals. During the day we had a look around the home and because the residents have dementia, which affects their ability to communicate fully, we made time during the inspection to closely observe the interaction between the staff and people living there so that we were able to judge their wellbeing. We also had opportunities to talk with Care Homes for Older People Page 6 of 29 the residents, their visitors and the staff to get their opinions. We looked at information belonging to four people and some of the of the staff files. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records. The manager had sent us the Annual Quality Assurance Assessment (AQAA) she had completed prior to the inspection. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The detail given to us in the AQAA was detailed and informative and the manager gave us examples to underpin what she had told us. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 29 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Using the information in their literature, people are able to make an informed decision about moving into 57 Crabbe Street. Evidence: Crabbe Street has been caring exclusively for people who have a diagnosis of dementia for the past nine years. The homes statement of purpose and their information brochure, which were updated in 2009, is written in an easy to read style and contains all the information required and is full of extra details about the home and its location. There are also informative brochures, including Before entering and residential Home and Having your say both produced by the local authority. The brochure contains photographs of the home and of people enjoying social activities and comments made by the residents over the previous year. One comments was I enjoyed the New Year Party - I enjoyed my sherry. and I like it when my grandchildren come to visit. We can spend time in the garden. Care Homes for Older People Page 11 of 29 Evidence: The brochure also gives information about local shops and amenities and also contains a useful question and answer page. The manager told us that a social worker carries out the initial assessment and the information is passed onto the home, then a senior staff member will visit the prospective resident either in their own home or at hospital to make their own assessment, to update the information already collected and to gather extra information from the new resident and their relatives. During this visit a form is completed that checks that the person fits the homes admission criteria and once completed it is signed and a copy is given to the resident as confirmation that the home can meet their needs. During the inspection we looked at four residents files which included assessments and care plans. We saw that the assessments were detailed and noted that information gathered during the assessment process was detailed enough to allow a good quality care plan to be produced from it. Peoples assessed needs were reflected in the care plans, the care plan of one person who was assessed as being at risk nutritionally, instructs the carer to monitor their food intake, to offer food supplement drinks, to regularly check their weight and to take action if they lose weight. Another person with poor mobility, was reported as being at risk because they get up during the night and will leave their room. A pressure mat is provided to alert staff if the resident gets out of bed so they can quickly assist them. In the Annual Quality Assurance Assessment (AQAA) the manager told us, Due to the urgency of many admissions from hospital it is not always possible for a resident to personally visit the home. We provide much information to assist with choice of home and liaise closely with family who visit on a persons behalf. Crabbe Street doesnt offer an intermediate care service. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are of a good quality and work is taking place to make them more person centred, people are allowed to make decisions about their lives. Evidence: We examined four care plans during our visit to the home, they reflected the needs of the person involved and we saw notes on them that shows they have been reviewed by the key worker since they were first written. They contained risk assessments that are developed to minimise the risk of harm in peoples every day activities, which enable them to live a full and active life without being restricted unreasonably. The care plans are written in a way that records the persons needs but do not properly reflect the residents personality or their personal preferences. In one of the care plans we saw it said that the person involved listens to music, likes TV, but that some types of programmes can make them anxious, it doesnt go on to explain what type of music the person is fond of or which television shows causes them upset. The manager told us that she recognised that the care plans could be more person centred and that there is a meeting planned in the near future involving all the Suffolk local Care Homes for Older People Page 13 of 29 Evidence: authority homes when they will be discussing care plans and will possibly be developing a more person centred approach. In the AQAA the manager told us that, We have developed and implemented a care planning programme to improve staff skills in maintaining and monitoring individual care plans. The home has a key worker system in place which the manager tells us, Allows for close continuity in the delivery of care. We saw evidence that peoples health care needs are met, we saw copies of specialist reports on file such as speech and language and psychology. People are encouraged to keep their own doctor, if they are unable to they are registered with a practise local to the home. Doctors and other heath care professional visits are recorded along with any treatment given. The AQAA also said, We have a team leader who is designated champion for fall prevention who attends regular meetings and who completes assessments. These assessments will identify nutritional needs that may relate to general health and falls prevention. The manager told us that staff receive in house training for infection control and one of the team leaders holds the responsibility to monitor and supervise controls in place. The home sends a representative to the NHS Network Group, which is a support group to help care homes to develop good infection control practises and to maintain high standards. We examined the medication and the way it was managed, we found that there were no omissions in the records and that the medication is stored as required. Each bedroom has a locked cabinet where each individuals medication is stored and people who are assessed as able to manage their own tablets are supported to do so. The staff receive medication training from the pharmacy that provides the medication to the home. Only staff that have been assessed as capable are allowed to dispense medication and they will shadow experienced staff on the medication round before they do it independently, this ensures that the risk of medication errors are minimised. We saw evidence that, as well as training, the pharmacist from Boots the Chemist also carry out regular audits of the homes medication and its storage. Induction training includes keeping confidences and we observed that interaction between the staff and people living in the home was easy and relaxed, staff listened to Care Homes for Older People Page 14 of 29 Evidence: what people had to say and responded in a way that showed respect and consideration to their feelings. When not in use private information is stored in a locked cupboard in the office and is not left lying around in communal areas. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service offers a varied range of meaningful activities and offer good food in a relaxed and homely atmosphere. Evidence: The home is divided into five areas where people live and eat in small groups. Each area has its own comfortable lounge, dining area and kitchen where residents can prepare drinks and snacks. There are several areas throughout where people can sit, which range from busy areas with lots going on to quiet areas where they can sit alone. The AQAA says that, The Staff rota incorporates 20 hours per day worked by support carers. Twelve hours of this time is dedicated to enhancing and improving quality of daily life and social activities. Various activities are offered such as one-to-one, group reminiscence, keep fit, flower arranging, craft making, individual outings to shops etc, themed evening entertainment, a monthly lunch club is enjoyed by those wishing to partake and external group outings are organised. The manager informed us that, The home has liaised with the Suffolk College, which has resulted in an activity programme including musical memories, two students visit Care Homes for Older People Page 16 of 29 Evidence: the home on a weekly basis for a group session. This has enhanced the overall Activity Programme. The people we spoke to told us that they were happy with the activities they were offered and one said, I enjoy taking part in some things, but Im just as glad I dont have to attend everything. The gardens are safe, secure and attractively maintained. There are bird feeders and a well stocked pond that has been protected with a fitted metal grid. There are a number of secluded areas that have seating and there is level access for wheelchair users. We were assured that people are supported to follow their faith; people can continue to attend their own place of worship or attend the services that are held in the home. Mealtimes allow people to make choices for themselves, while being supported and enabled. The dining rooms are small and intimate. Residents eat in small groups and we observed lunch being served in one of the lounges. The was a relaxed atmosphere and people were able to eat at their own pace. The meal looked appetising and smelt appealing, people are able to choose from two main meals and an alternative will be provided on request. The tables were attractively set and condiments and drinks were available on the tables. The manager told us that, Families and friends are able to visit their relatives at any time. We actively encourage relatives to join their family for meals and residents are fully involved with menu choice. Mealtimes are often adjusted to meet individual preferences and needs and specialised menus are catered for. For occasions when an individual requires assistance with their meals, a room is set aside to ensure privacy and dignity. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be assured that the home will listen to them if they are unhappy and take action to investigate any complaints they make. Evidence: The manager feels that she has a hands on approach and an open door policy and told us that she speaks to residents every day and makes it her business to speak to family and friends when they visit. We were told that they havent received any complaints since their last inspection and we havent received any sent directly to us either. On admission residents or their advocate are supplied with detailed information about how to make a complaint, including a copy of the leaflet Having Your Say The home is owned and managed by the Suffolk County Council and manage complaints under the councils complaints procedure, we examined the procedure and found that it provided the necessary information on how to raise any concerns or complaints about the service. We had a discussion with the manager about the possibility of them adopting a policy of recording all complaints and concerns no matter how minor, it is considered good practise as it gives people confidence that the home will take all matters raised seriously and that they will listen to everything that they have to say. Care Homes for Older People Page 18 of 29 Evidence: People are protected from abuse by staff training, we saw that the training files showed evidence that staff have undergone Safeguarding of Vulnerable Adults training (SOVA) and there are policies in place around recognising and reporting abuse. All the staff we spoke with, whether carers or ancillary staff, were very clear about their duty of care and the actions they would take if they had any cause to suspect a situation was potentially abusive. The manager explained the system used by the home to manage residents personal finances. As a local authority home, money is kept in a central account but individual balances are available. Receipts are kept and statements are offered to residents or filed in their financial records. We saw that there was a clear audit trail and noted that the residents are paid interest on any money that is kept by the authority. In the AQAA she told us, All financial records comply with Suffolk County Council Policy & Procedures. Written records are kept and periodically audited by outside auditors. Individuals are assessed, their views and wishes, together with assistance from their family or advocates are adhered to. Residents are offered a three-monthly statement outlining all financial transactions (this can be more frequent if required). Since the implementation of the mental capacity act, staff at the home have received training in the act including the deprivation of liberty. When we examined peoples care files we saw completed risk assessments on the deprivation of liberty, which had been done to ensure individual choices are upheld in a safe manner. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home offers a safe and comfortable environment, which is designed to maintain peoples independence. Evidence: During a tour of the building we saw that the home was clean, furnished comfortably and safe. The whole building has been decorated and refurbished to a high standard. Sainsburys donates flowers to the home every week and there were beautiful, sweet smelling bouquets throughout the home. There is a system in place for staff to notify the handy person of any repairs needed. The staff and residents told us that maintenance was of a high standard and that the handy person was always happy to help with small tasks. The bedrooms are usually decorated when they become vacant and on the day of the inspection the maintenance person was busy planning some general maintenance work in the home. People have free access to interesting and safe grounds, where they can sit and enjoy the garden, there are objects of interest such as bird feeders and a well stocked pond. In the AQAA the manager tells us that, The grounds are large and vary with suitable walking areas that are accessible from different parts of the building. Sitting areas are plentiful and also accessible. The attractive gardens are well maintained by the Handy person/Gardener with assistance from outside agencies. The Courtyard is being Care Homes for Older People Page 20 of 29 Evidence: adapted to include raised flower beds. Residents are involved in this project. The bedrooms we saw are all furnished to requirement and some people have bought in their personal furniture and possessions that have made the rooms individual to the occupant. The rooms all have en suite facilities and each each group area has a bathroom with an assisted bath. The manager assured us that on admission, individuals are assessed and their needs are met, this will include alterations or adaptations required to facilitate daily living and prolong independence . Personal protective equipment was available for staff use to enable them to maintain good infection control and we saw staff using it appropriately. The AQAA says that, Health, Safety & Hygiene matters are a priority. The Department of Health Essential Steps have been referenced to enhance hygiene. Guidelines to prevent the spread of infection are displayed in all wash room areas. There are more than ample hand washing facilities in many areas of the building. Each unit has its own appropriate laundry facilities thereby reducing the risk of cross infection. The homes infection control Champion regularly attends meetings. An Infection Control Monitoring System is in place for all areas and aspects of Hygiene. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of their roles and responsibilities and are qualified. The home has recruitment policies and procedures in place that are being followed. Evidence: Staff personnel files are kept at the home and we examined four of them in detail. They held all the information and documents that are required to be kept as set out in schedule 2 and 4 of the care home regulations. Staff members we spoke to confirmed that all the checks that safeguard people are carried out before people start working at the home and that they took part in induction training when they first joined the workforce. In the Annual Quality Assurance Assessment (AQAA) the manager said, The staffing ratio is high, i.e. one care staff to a maximum of seven residents, with the additional support of a support worker/resident carer. Waking night staff includes three residential carers and a team leader who is free to assist in all areas of the home and is responsible for safety and security. The manager told us that she carries out spot checks on staff both during the day and at night and continually monitors the quality of care by direct observation. We noted from the staff files that there is evidence that people get supervision and Care Homes for Older People Page 22 of 29 Evidence: that regular staff meetings are held and staff are encouraged to add items to the agenda. In the AQAA we were told, The Senior Team regularly supervise staff during which training needs will be identified. The majority of supervision is carried out on a live basis, i.e. daily monitoring and discussion. This type of supervision supports a carer in their every day duty. This is particularly beneficial in respect of the client group that we care for. All aspects of a staff members training is monitoring, especially in relation to Moving & Handing; Fire safety; First aid; Food hygiene and Infection Control. In their survey one staff member told us that, I have regular supervision so I can express my concerns or needs. We also have regular group meetings. The care staff we spoke with displayed a good knowledge of the people in the home and understood their needs. Information given to us in the AQAA completed by the manager, tells us that all the staff have undertaken induction training and that the home has exceeded the minimum requirement that 50 of its care staff must have attained the NVQ2 in care or its equivalent, in fact it tells us that 28 out of 35 carers have their NVQ qualification. The staff records show evidence that the home offers the mandatory training, and staff have access to specialist training suitable for the assessed needs of the people living in the home. Training that has taken place includes dementia awareness, understanding mental health, medication, diabetes awareness, dealing with challenging behaviour, protection of vulnerable adults, infection control and fire training. The manager has assessed the staffs training needs and has developed a training matrix and as part of a local authority the staff have access to a large training pool. In the AQAA the manager says, We adhere to County Policy as outlined by Safer Business Associates, Safer Employment for Recruitment and Selection of People to work with Vulnerable Adults in Suffolk. The staff we spoke to and the returned surveys confirmed that they were given ample opportunities to continue their further development through training. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well run and the ethos of its management is empowering to the people living in it. Evidence: The manager was at the home when we arrived, she facilitated the inspection, which was done in an open and helpful way and everything we asked to see was quickly produced. The manager has been consistently running the home to a high standard for the last eight years and has extensive qualifications and experience of caring for those with dementia. She has qualifications in nursing, social work, is an NVQ assessor and has a qualification in dementia care mapping. We saw evidence in the way the home operated and the way she manages the paperwork that she is very organised and comments we received indicated that she is well liked by the people living in the home and the staff. While taking to the manager is became evident from the way she talked that she was committed to offering the best service possible to the residents of the home and had a good understanding of Care Homes for Older People Page 24 of 29 Evidence: the services policies and procedures and was able to implement them. We saw copies of the monthly audits she carries out and submits to her line manager as part of the local authorities monitoring process, she assured us that the responsible person or his representative carries our regular regulation 26 visits after which a report is written and action is taken if necessary. One staff member commented that, The manager is always there for us and is happy to talk through problems with us. Another carer said, The home provides in house training, which is better than going elsewhere where the training doesnt always relate to 57 Crabbe Street. The AQAA was well written and was delivered to us within our timescales. In it the manager gave us all the information we needed and gave us examples of good practise to evidence what it told us. She also identified areas that needed improvement and told us how they would implement the improvements. In it we were told that, We have worked closely with the H & S and property department to develop an emergency plan. This is in relation to flood, fire, utility failure and also an infection outbreak. A mock disaster event has been successfully staged. Workplace handling coordinators have undertaken training to assess equipment for residents in addition to equipment for care staff. Maintenance records and fire hazard reporting records were seen and were comprehensively completed. The homes fire prevention and procedures staff information and guidance booklet is comprehensive and an excellent piece of work carried out by the manager and her senior team leader. It clearly sets out peoples responsibilities and lists what actions must taken in the event of a fire or an alarm going off. Information given to us in the AQAA shows that all relevant safety checks are carried out on the homes equipment. For example the hoists were last serviced in October 2009, the portable electrical equipment was last tested as being safe to use in May 2009 and the gas appliances were serviced in February 2009. We didnt identify any heath and safety issues during our visit. The home has a quality assurance policy and procedure and send surveys to staff, people in the home and their relatives, the information received is collated and a report is produced and a copy made available so that people can see what areas need attention and what steps are going to be taken. The home has its own news letter full of news about what has been happening at the home and plans for future outings and activities. Some of the articles are written by the residents. The outcome of the most Care Homes for Older People Page 25 of 29 Evidence: recent quality assurance survey has been reported in the news letter along with a note of thanks from the manager to the people who took part in it. In the AQAA the manager told us that, Quality Assurance Monitoring is a priority to assist with all areas of the care delivery and staff involvement. Feedback is sought from residents, relatives, professionals and staff to include individual views to provide holistic care. Through this assurance monitoring we are able to continually plan and improve an evolving service. Before the inspection we sent our own surveys to the people living in the home, the staff and other professional involved in service. All of the comments we received in the surveys were positive. One resident said in their survey, If you wish to retire in a very good home put your name down now. As all my friends know how well and satisfied I am. Another person commented, All the staff are excellent. One of the health care professionals who responded to our survey said, If I was choosing a place for my Mum, 57 Crabbe Street would be there at the top of my list. They also commented, The home always appears calm and friendly whenever I need to visit. The staff are always helpful and I have never seen a resident in distress and being ignored. The manager told us that she will always make herself available if anyone living in the home or their relatives wanted to talk to her. House meetings are held where people are encouraged to speak their mind about how the home is run and how it can be improved. Records are kept of these meetings and we noted that a copy had been posted on the notice board. The organisations polices and procedures are comprehensive and are kept under review and are changed as legislation dictates. The records we sampled were kept up to date, information is stored appropriately, personal details are stored away from public gaze and are kept confidential. Staff are asked to read and sign the organisations policy on confidentiality when taking up their post. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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